Providing you take common-sense precautions, visiting Cuba poses no particular health risks. In fact, some of the most impressive advances made by the revolutionary government since 1959 have been in the field of medicine and the free healthcare provided to all Cuban citizens. Despite all the investment, Cuba’s health service has been hit hard by the US trade embargo, particularly in terms of the supply of medicines. It’s essential to bring your own medical kit from home, including painkillers and any prescription drugs that you use, as availability is limited in Cuba.
No vaccinations are legally required to visit Cuba, unless you’re arriving from a country where yellow fever and cholera are endemic, in which case you’ll need a vaccination certificate. It is still advisable, however, to get inoculations for hepatitis A, cholera, tetanus and to a lesser extent rabies and typhoid. A booster dose of the hepatitis A vaccination within six to 12 months of the first dose will provide immunity for approximately 10 years.
Bites and stings
Despite Cuba’s colourful variety of fauna, there are no dangerously venomous animals on the island – the occasional scorpion is about as scary as it gets, while the chances of contracting diseases from bites and stings are extremely slim. Cuba is not malarial and mosquitoes are relatively absent from towns and cities due to regular fumigation. They are, however, prevalent in many rural areas. Basic, common-sense precautions include covering your skin, not sitting out at dusk, closing windows at this time, and using DEET repellent.
There are occasional outbreaks of dengue fever, a viral infection spread by mosquitoes. It can occasionally be fatal, though usually only among the very young or old or those with compromised immunity; reported number of deaths in Cuba have been in single figures, and serious cases are rare. There’s no vaccine, so prevention is the best policy. Avoid getting bitten by mosquitoes, and be aware that though more common after dusk, mosquitoes can strike throughout the day. Symptoms develop rapidly following infection and include extreme aches and pains in the bones and joints, severe headaches, dizziness, fever and vomiting. Should you experience any of the above symptoms, seek medical advice immediately – early detection and access to proper medical care eases symptoms and lowers fatality rates to below 1%.
More widespread wherever there is livestock, ticks lie in the grass waiting for passing victims and burrow into the skin of any mammal they can get hold of. Repellent is ineffective, so your best form of defence is to wear trousers tucked into socks. It is possible to remove ticks with tweezers, but make sure that the head, which can easily get left behind, is plucked out along with the body. Smearing them first with Vaseline or even strong alcohol leaves less of a margin for error. Minuscule sand flies can make their presence felt on beaches at dusk by inflicting bites that cause prolonged itchiness.
A cholera outbreak in eastern Cuba in 2012 caused three fatalities, while another in Havana in early 2013 was the country’s biggest outbreak in decades; dozens of people were infected, but none fatally so. As cholera appears in epidemics rather than isolated cases, you will probably hear about it should it be present when you visit. The disease is carried by contaminated water or food and is characterized by sudden attacks of diarrhoea with severe cramps and debilitation. Cholera can prove fatal if untreated, but foreign visitors are at a very low risk of contracting it.
Food and water
Due to the risk of parasites, drinking tap water is never a good idea in Cuba, even in the swankiest hotels. Whenever you are offered water, whether in a restaurant, paladar or private house, it’s a good idea to check if it has been boiled – in most cases it will have been. Bottled water is available in convertible-peso shops and most tourist bars and restaurants.
Although reports of food poisoning are few and far between, there are good reasons for exercising caution when eating in Cuba. Food bought on the street is in the highest-risk category and you should be aware that there is no official regulatory system ensuring acceptable levels of hygiene. Self-regulation does seem to be enough in most cases, but you should still be cautious when buying pizzas, meat-based snacks or ice cream from street-sellers. Power cuts are common and there is no guarantee that defrosted food is not subsequently refrozen. National-peso restaurants can be equally suspect, particularly those in out-of-the-way places.
Sun exposure and heat issues
Cuba’s humid tropical climate means you should take all the usual common-sense precautions: drink plenty of water, limit exposure to the sun (especially between 11am and 3pm) and don’t use a sunscreen with a protection factor of less than 15, and if you’re fair-skinned or burn easily, no lower than 25. You may find sunscreen difficult to find away from hotels and convertible-peso shops, so be sure to pack some before taking any trips into less-visited areas.
Hospitals, clinics and pharmacies
Don’t assume that Cuba’s world-famous free health service extends to foreign visitors – far from it. In fact, the government has used the advances made in medicine to earn extra revenue for the regime through a system of health tourism. Each year, thousands of foreigners come to Cuba for everything from surgery to relaxation at a network of anti-stress clinics, and these services don’t come cheap. There are specific hospitals for foreign patients and a network of clinics, pharmacies and other health services targeted specifically at tourists, run by Servimed. The only general hospital for foreigners, as compared to the smaller clinics found in around half-a-dozen cities and resorts across the island, is the Clínica Central Cira García in Havana.
If you do wind up in hospital in Cuba, one of the first things you or someone you know should do is contact Asistur, which usually deals with insurance claims on behalf of the hospital, as well as offering various kinds of assistance, from supplying ambulances and wheelchairs to obtaining and sending medical reports. However, for minor complaints you shouldn’t have to go further than the hotel doctor, who will give you a consultation. If you’re staying in a casa particular your best bet, if you feel ill, is to inform your hosts, who should be able to call the family doctor, the médico de la familia, and arrange a house-call. This is common practice in Cuba where, with one doctor for every 169 inhabitants, it’s possible for them to personally visit all their patients.
There is no single emergency number for ringing an ambulance, but you can call 105 from most provinces and 7 838 1185 or 7 838 2185 to get one in Havana. You can also try Asistur’s emergency Havana numbers (7 866 8339 and and 7 866 8527).
There are two types of pharmacy in Cuba: national-peso places for the population at large; and Servimed pharmacies aimed primarily at tourists, charging in convertible pesos and usually located within a clínica internacional. Tourists are permitted to use the antiquated national-peso establishments but will rarely find anything of use besides aspirin, as they primarily deal in prescription-only drugs. The Servimed pharmacies only exist in some of the largest towns (as detailed throughout the guide), but even these don’t have the range of medicines that you might expect.